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NPI 1346743945

NPI 1346743945 : JANA RASHKIN LMSW, MS, MA : STONY BROOK, NY

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General NPI Number Information
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    NPI Number           |    1346743945
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    Entity Type          |    Individual 
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    Provider Name        |    JANA RASHKIN LMSW, MS, MA
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    03/10/2018
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    Last Update Date     |    03/10/2018
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Provider Practice Location Address
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    Address Line         |    215 HALLOCK RD 
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    City                 |    STONY BROOK
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    State                |    NY
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    Zip                  |    11790-3078
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    Country              |    US
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    Telephone            |    631-551-5095
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    Fax                  |    631-675-6306
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Provider Business Mailing Address
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    Address Line         |    215 HALLOCK RD 
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    City                 |    STONY BROOK
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    State                |    NY
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    Zip                  |    11790-3078
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    Country              |    US
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    Telephone            |    631-551-5095
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    Fax                  |    
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    104100000X
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    Taxonomy Name        |    Social Worker
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    License Number       |    098115
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    License Number State |    NY
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